Mass vaccination programme aimed at eradicating measles, mumps, and rubella in Sweden: first experience.

Christenson, Brith; Böttiger, M; Heller, L.

doi:10.1136/bmj.287.6389.389

Cited by 56 publications

(10 citation statements)

References 8 publications

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“…1 45 This paper describes the vaccination coverage, serological immunity, and morbidity among Swedish children four years after the introduction of the new vaccination programme. Subjects and methods VACCINATION COVERAGE Preschool children in Sweden are immunised at child health centres.…”

Section: Introductionmentioning

confidence: 99%

Swedish experience of two dose vaccination programme aiming at eliminating measles, mumps, and rubella.

Böttiger¹,

Christenson²,

Romanus³

et al. 1987

BMJ

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101

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In 1982 a two dose regimen was introduced in Sweden for the combined vaccination against measles, mumps, and rubella of children aged 18 months and 12 years. Since 1977 about half of the preschool children were vaccinated against measles annually, and since 1974 about 80% of 12 year old girls were vaccinated against rubella. During the period 1982 to 1985 90-93% of the eligible age cohorts of 18 month old children and 88-91% of the 12 year old children were inmunised with the new combined vaccine. A study in 1982 of about 140 18 month old children who were nearly all seronegative before vaccination showed that 96%, 92%, and 99% seroconverted against measles, mumps, and rubella, respectively. A second study was carried out in 1983 of 247 12 year old children, of whom 11% lacked antibodies to measles, 27% to mumps, and 45% to rubella. This showed seroconversion in 82% and 80% against measles and mumps, respectively, and all children seroconverted against rubella. In the latest study in 1985 of 496 12 year olds 9% and 13% were seronegative against measles and mumps before vaccination, and 41% against rubella. Of these, 88% seroconverted to measles and 80% to mumps, and all converted to rubella when sera were tested bythehaemolysis in gelmethod. Aftera neutralisation test against measles as well all children showed immunity to the disease.

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Section: Introductionmentioning

confidence: 99%

Swedish experience of two dose vaccination programme aiming at eliminating measles, mumps, and rubella.

Böttiger¹,

Christenson²,

Romanus³

et al. 1987

BMJ

Self Cite

101

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“…18 Data regarding vaccinations before and after chemotherapy were obtained by a questionnaire and verified through vaccination certificates. All children had received the primary vaccination at 18 months.…”

Section: Immunization Programmentioning

confidence: 99%

Current Chemotherapy Protocols for Childhood Acute Lymphoblastic Leukemia Induce Loss of Humoral Immunity to Viral Vaccination Antigens

et al. 2002

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ABSTRACT. Objective. To evaluate viral vaccination immunity and booster responses in children treated successfully for acute lymphoblastic leukemia by chemotherapy and to study the response to treatment of antibody-producing plasma cells that are important for persistence of humoral immunity.Methods. Forty-three children who were in continuous first remission for a median of 5 years (range: 2-12 years) were studied. Before the leukemia was diagnosed, all children had been immunized against measles, mumps, and rubella according to the Swedish National immunization program. We analyzed levels of serum antibodies against measles and rubella by enzyme immunoassays. Avidity tests for measles antibodies were concomitantly performed by enzyme-linked immunosorbent assay for measles virus immunoglobulin G detection. The proportion of plasma cells in bone marrow was studied by flow cytometry at different times during treatment and follow-up. Children who lacked protective levels of antibodies to vaccination antigens were reimmunized. Serum was collected 3 months after immunization to assess vaccination responses.Results. After completion of the treatment, only 26 of the 43 children (60%) were found to be immune against measles and 31 (72%) against rubella. The proportion of bone marrow plasma cells decreased during treatment but returned to normal after 6 months. Revaccination caused both primary and secondary immune responses. Six of the 14 children without immunity failed to achieve protective levels of specific antibodies against measles and 3 against rubella.Conclusions. Our finding of loss of antibodies against measles and rubella in children treated with intensive chemotherapy suggests that reimmunization of these patients is necessary after completion of the treatment. To determine reimmunization schedules for children treated with chemotherapy, vaccination responses need to be studied further. A n increasing number of children survive leukemia as a result of improved and more intense chemotherapy. Other factors that influence outcome are improved supportive care including platelet transfusions, treatment with growth factors such as granulocyte colony-stimulating factor, and prophylactic antibiotic treatment. 1,2 Few studies have focused on potential long-term immunologic consequences of chemotherapy in survivors of childhood leukemia. Short-term (Ͻ2 years) effects of chemotherapy on immune function have previously been documented in children who were treated for malignancies, including acute lymphoblastic leukemia (ALL). 3,4 In those children, severe Band T-cell depletion results in clinical complications related to immune incompetence, 5,6 although the total B-and T-cell counts resolve quantitatively 6 months to 1 year after cessation of therapy. [7][8][9][10] In earlier studies, children who were treated with chemotherapy had lower levels of antibodies against common viral vaccination antigens such as measles, mumps, rubella, and polio. 11 The clinical implications, if any, of this finding are not completely und...

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“…For example, measles vaccination in Sweden is recommended at 18 months of age [4], in the United Kingdom and the USA between 12 and 15 months [5,6], in Canada at 12 months of age [7], and the World Health Organization recommends vaccination at 9 months of age in the developing countries. Maternally derived measles antibodies are thought to be the major cause of primary vaccine failure when measles vaccine is given at early ages [8].…”

Section: Introductionmentioning

confidence: 99%

Measles vaccine efficacy during an outbreak in a highly vaccinated population: Incremental increase in protection with age at vaccination up to 18 months

Serres¹,

Boulianne²,

Meyer

et al. 1995

Epidemiol. Infect.

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SUMMARYDuring a large measles outbreak in Quebec City in 1989, two investigations conducted in parallel evaluated the relative risk of measles and measles vaccine effectiveness with respect to age at vaccination. The study was a school-based case-control study including 563 cases and 1126 classmate controls. The second was a cohort study of the siblings of school cases including 493 siblings aged between 1 and 19 years. The relative risks (RR) of measles were similar in both settings and the trend towards increased vaccine efficacy with increasing age at vaccination was highly significant (P < 0 00 1). Vaccine efficacy rose from 85 % in children vaccinated at 12 months of age to > 94% in those vaccinated at 15 months and older. Even for children vaccinated at or after 18 months of age, the RR of measles was reduced when compared with children vaccinated between 15 and 17 months of age (RR 061, CI 95% 0-33-1-15). Small changes in the timing of initial measles vaccination can have a major impact on vaccine efficacy.

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Mass vaccination programme aimed at eradicating measles, mumps, and rubella in Sweden: first experience.

Cited by 56 publications

References 8 publications

Swedish experience of two dose vaccination programme aiming at eliminating measles, mumps, and rubella.

Swedish experience of two dose vaccination programme aiming at eliminating measles, mumps, and rubella.

Current Chemotherapy Protocols for Childhood Acute Lymphoblastic Leukemia Induce Loss of Humoral Immunity to Viral Vaccination Antigens

Measles vaccine efficacy during an outbreak in a highly vaccinated population: Incremental increase in protection with age at vaccination up to 18 months

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